Pazopanib can be used to treat a kind of kidney cancer called renal cell carcinoma. Pazopanib can also be used to treat certain types of soft tissue sarcomas.

WHAT IS PAZOPANIB?

Pazopanib is a type of treatment called a multikinase inhibitor. Kinases are important proteins for the body that regulate the way cells grow and divide.

HOW DOES PAZOPANIB WORK?

Pazopanib acts by blocking signals within the cancer cells that make them grow and divide. Blocking the signals causes them to die.

Pazopanib can also halt the development of new blood vessels inside cancer cells. This reduces the supply of oxygen and nutrients, making the tumor shrink or stop growing. Drugs that interfere with the growth of blood vessels this way are called angiogenesis inhibitors or anti-angiogenics.

WHEN IS PAZOPANIB USED?

Pazopanib is used to treat people with kidney cancer that has spread to other parts of the body (advanced renal-cell cancer). It can also be used to treat people with certain types of advanced soft-tissue sarcoma who have already had chemotherapy.

WHAT DOES PAZOPANIB LOOK LIKE?

Pazopanib is a tablet. It comes in two dose sizes: 200-mg tablets, which are pink, and 400-mg tablets, which are white.

HOW IS PAZOPANIB TAKEN?

The tablets should be swallowed whole with a glass of milk either one hour before eating or at least two hours after a meal. Pazopanib should not be taken with grapefruit juice. You should not crush up the tablets.

Pazopanib is normally taken once daily, and should be taken at the same time each day.

POSSIBLE SIDE EFFECTS OF PAZOPANIB

Each person reacts differently to cancer treatment. Some people have very few side effects, while others may develop more. The side effects described here will not affect everyone who is treated with the drug.

We outline the most commonly side effects, though we have left out the rarer ones. If you notice you develop any side effects that are not listed here, talk to your doctor or specialist nurse.

HIGH BLOOD PRESSURE

Pazopanib can cause high blood pressure in some people. Tell your doctor if yours is already high.

Your blood pressure will be checked periodically over the first six months of treatment. If you develop high blood pressure, it will most likely happen in the first weeks of taking the medication. If you develop high blood pressure, you will be prescribed medication to help regulate it.

DIARRHEA

This is the most common side effect of pazopanib, and it develops around a week after the treatment. Normally, this can be easily controlled with drugs, so tell your doctor if your diarrhea is severe or ongoing. It's important to drink lots of fluids if you have diarrhea.

NAUSEA AND VOMITING

Your doctor can prescribe antiemetic drugs to prevent or greatly reduce your nausea or vomiting. If your nausea remains uncontrolled or continues, tell your doctor.

Some of these drugs can cause constipation. Tell your doctor or nurse if this is a problem.

LOSS OF APPETITE

Some people lose their appetite. This can be mild and last for a few days. If it doesn't get better, request to see a dietitian or specialist nurse at your hospital. They can give you advice on how to improve your appetite and maintain a healthy weight.

CHANGES IN TASTE

You may notice that food tastes different. A dietitian or specialist nurse can give you advice on ways to cope with this side effect.

TIREDNESS (FATIGUE)

Tiredness is a common side effect, especially toward the end of treatment and for a few weeks after the treatment has finished. It is important that you try to pace yourself and rest as much as you need to. Try to balance this with light exercise, such as taking short walks. If you feel drowsy, don't drive or operate heavy machinery.

ABDOMINAL PAIN

Some people have abdominal pain or discomfort when they take pazopanib. Tell your doctor if this happens.

CHANGES TO YOUR HAIR

Changes to the hair happen less often than changes to the skin, though they sometimes develop after three months or more.

Your eyelashes may grow longer and become curlier than usual. Men may notice that their beard does not grow as much. You may notice that the hair on your head becomes more fine, curly, or fragile.

Few people have hair loss. If this happens, it normally happens gradually over several months.

These changes are normally temporary and get better little by little once the treatment is over.

SKIN CHANGES

Skin changes such as rashes, redness, dryness, or itchiness are rather common. Your skin may lose part some of its color, turning lighter or yellowish. These side effects are normally minor. Tell your doctor or nurse if you have any of these symptoms. They can recommend creams or lotions you can use; also, they can prescribe drugs to relieve the itchiness.

HAND/FOOT SKIN REACTION

You may notice reddening on the palms of your hands of the soles of your feet. At times, the hands and feet become painful and inflamed. You may also have changes in sensation, such as numbness or tingling. Tell your specialist if this happens.

Sometimes, if they pain does not go away or if blistering occurs, your doctor may need to lower the dose of pazopanib or interrupt the treatment. Occasionally, people may need to stop the treatment entirely.

HOT FLASHES

You may have hot flashes while taking pazopanib. Tell your doctor if this becomes a problem.

HEADACHES

Some people find that pazopanib gives them headaches. If this happens, tell your doctor or nurse. They can give you painkillers to help.

MUSCLE PAIN

Some people experience muscle pain while taking the treatment. If this is your case, your doctor can prescribe painkillers to help.

DIZZINESS

You may become slightly dizzy. Tell your doctor if this becomes a problem. Pazopanib may affect your ability to drive.

BUILD-UP OF FLUID

This can affect different parts of the body. The most common effect is swelling of the ankles or the area around the eyes. Fluid build-up often goes away without treatment, though if it doesn't, diuretics can help you get rid of some of the liquid. A short course of steroids may also be of help.

THYROID PROBLEMS

Pazopanib may cause your thyroid to function less efficiently. Symptoms of hypothyroidism may include tiredness, weight gain, constipation, pain, and a feeling of coldness or dryness of the skin. Tell your doctor if you develop any new symptoms. You may need to have a blood test to determine how well your thyroid is working.

SORENESS OF THE MOUTH AND MOUTH ULCERS

Your mouth may become sore or dry or you may develop small ulcers during your treatment. Some find that sucking on ice can help. Drinking lots of fluids and regularly brushing your teeth gently using a soft-bristled toothbrush can help lower the risk of this happening. Tell your doctor or nurse if you have any of these problems, as they can prescribe a mouthwash and drugs to prevent infection in the mouth.

RISK OF INFECTION

Pazopanib can reduce your number of white blood cells, which help fight off infection. White blood cells are produced by bone marrow. If your white blood cell count is low, you will be more prone to infection. A low number of white blood cells is called neutropenia.

The number of white blood cells normally increases gradually, returning to normal before your next chemotherapy treatment. You will have a blood test before the next treatment to check your white blood cells. It may sometimes be necessary to delay the treatment if your blood count shows that you still have a low number of white blood cells.

Contact your doctor or your hospital immediately if:

• your temperature rises above 38 ° C
• you suddenly feel unwell, even if your temperature is normal.

BRUISING AND BLEEDING

Pazopanib can reduce the production of platelets, which help the blood to clot. Tell your doctor if you have any unexplained bleeding or bruising, such as nosebleeds, bleeding gums, blood spots, or skin rashes. You may have a platelet transfusion if your platelet count is low.

ANEMIA (LOW RED BLOOD CELLS)

Pazopanib can reduce the number of red blood cells, which transport oxygen throughout the body. A low number of red blood cells is called anemia. This may make you feel tired and short of breath. Tell your doctor or nurse if you have these symptoms. You may need a blood transfusion if the number of red blood cells in your blood is too low.

EFFECTS ON THE LIVER

Pazopanib can change the way the liver functions. Your doctor will keep a close watch on your liver and have you take periodic blood tests to check that your liver is functioning properly. Tell your doctor if you develop pain in your right side.

HEART PROBLEMS

A very small number of people may notice a change in their heart rate. Your heartbeat may become more irregular or you may feel that your heart is beating too fast. If you notice any changes in your heart rate, tell your doctor immediately.

STROKE

In rare cases, pazopanib can increase a person's risk of having a stroke. Notify a doctor immediately if you or a family member or friend of yours notice that you have weakness or numbness in one arm or both, if you have difficulty speaking or drooping of the face, mouth, or eye.

ADDITIONAL INFORMATION ON PAZOPANIB

OTHER MEDICINES

Some drugs, including those bought over the counter in a store or pharmacy, may be harmful to you while you are taking pazopanib. Tell your doctor if you are taking any medicines, including over-the-counter medications, complementary therapies, and herbal medicines.

FERTILITY

This treatment may affect your ability to conceive. It is important that you talk to your doctor before beginning treatment.

CONTRACEPTION

Little is known about the effects of pazopanib on developing babies. Therefore, it is not recommendable to become pregnant while taking this drug.

It is unknown whether pazopanib is present in semen or vaginal fluid. In order to protect your partner, it is safest to avoid having sex or use a barrier contraceptive device for about 48 hours after the chemotherapy.

BREASTFEEDING

There is a potential risk that pazopanib may be present in breast milk, and therefore women are recommended not to breast feed during the treatment and for a few months afterward.

HOSPITAL ADMISSION

If you are admitted to the hospital for any reason not related to cancer, it is important that you tell your doctors and nurses caring for you that you are receiving treatment with pazopanib.

OTHER ISSUES TO KEEP IN MIND ABOUT PAZOPANIB CAPSULES

It is important to take your capsules as your doctors said.

Keep them in a safe place out of the reach of children. Pregnant women should not handle the capsules.

If you forget to take a capsule, do not take a double dose. Tell your doctor and maintain your normal dose schedule.

Tell your doctor if you vomit right after taking the capsules. You may have to take another dose. Do not take any more until you talk to your doctor, nurse, or pharmacist.

If your doctor decides to halt your treatment, return the remaining capsules to the hospital. Do not flush them down the toilet or throw them away.